Article Text

Download PDFPDF
Case report
Diffuse large B-cell lymphoma of the rectum in a patient with Crohn’s disease
  1. Adam Joseph Hardy1,
  2. Ionica Stoica2,
  3. David Edward Kearney3 and
  4. Diarmuid S O'Riordain4
  1. 1Department of Paediatric Surgery, Our Lady's Children's Hospital, Dublin, Ireland
  2. 2Department of General & Vascular Surgery, Tallaght Hospital, Dublin, Ireland
  3. 3Department of Surgery, University Hospital Limerick, Limerick, Ireland
  4. 4Department of Surgery, Tallaght University Hospital, Dublin, Ireland
  1. Correspondence to Adam Joseph Hardy; hardyadams01{at}gmail.com

Abstract

A 62-year-old man presented to our institute with diarrhoea and dysuria on a background of subtotal colectomy and end ileostomy and biological therapy for Crohn’s disease. He was diagnosed with urinary tract infection and acute kidney injury (AKI). Renal ultrasound suggested left hydronephrosis, with renal protocol computed tomography (CT) showing a large pelvic mass. Magnetic resonance imaging (MRI) of the pelvis demonstrated a rectal tumour invading the bladder and compressing both ureters. He underwent cystoscopy, flexible sigmoidoscopy and positron emission tomography–CT and was diagnosed with stage IV non-Hodgkin’s diffuse large B-cell lymphoma. He was treated primarily with rituximab, cyclophosphamide, hydroxydaunomycin, oncovin and prednisolone chemotherapy regimen. He had ongoing urosepsis before admission for pelvic exenteration. He underwent cystoprostatectomy, excision of rectal stump and formation of ileal conduit. Histology showed no signs of residual malignancy. One year later, the patient was admitted to the intensive care unit with aspiration pneumonia, urosepsis and AKI. Despite maximal therapy, he developed multiorgan failure and passed away.

  • malignant disease and immunosuppression
  • inflammatory bowel disease
  • colon cancer
  • surgical oncology
  • cancer intervention

Statistics from Altmetric.com

Footnotes

  • Contributors This case report was written by AJH and IS. It was supervised by DEK, who provided corrections/updates upon completing multiple reviews of earlier drafts. DSOR oversaw the case report, provided advice on which endpoints to use for the report, as well as requested several key pieces of information be included, and also reviewed the final draft prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.